HomeMy WebLinkAbout1101 UNION AVENUE (2)Pre- Engineered Restaurant Fire Suppression Systems Report
AAA QUALITY SE tl,12C.
5300 SO. UNION
BAKEISMELD, CA 93307 -5426
601) 833 -5510 FAX 833 -5512
CU TOMER /
y
Name /d/
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Role
Address ®'
City State ZIPy
Telephone b & 0 - 325_ 7 :7'l Store No.
Owner or Manager
DATE OF SERVICE TIME A.M. P.MI
f%O i
ANNUAL SEMI= ANNUAL RECHARGE INSTALLATION RENOVATION
LOCATION OF SYSTE CYLINDERS UL 300
O S NOVE
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
U ® I 4
CY INDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
29. Replace systems covers
FUSE LINKS 360' F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
31. Slave system operational
FUEL SHUT -OFF ELECTRIC GAS SIZE
V k_ L„/
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
1. All appliances properly covered w /correct nozzles
2. Duct and plenum covered w /correct nozzles
3. Check positioning of all nozzles.
4. System installed in accordance w /MFG UL listing
5. Hood /duct penetrations sealed w /weld or UL device
6. Check if seals.intact, evidence of tampering
7. If system has been discharged, report same
8. Pressure gauge in proper range (If gauged)
9. Check cartridge weight (If applicable)
10. Hydrostatic test date
11. 6 year maintenance date
12. Inspect cylinder and mount
13. Operate system from terminal link
14. Test for proper operation from remote
15. Check operation of micro switch
16. Check operation of gas valve
17. Clean nozzles
18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS:
On this date, this pre- engineered fire s,p4ression system was inspected and operationally tested in accordance with the fire
suppression system requirements oJNF WA F -17A, 96 and the manufacturer's manual with the results indicated above.
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c-SERVICE ECHNICIAN PERMIT NO. 'DATE: TIME: AM PM -- _CUSTOM ER'S AUTHORIZED AGENT
The above`Fvice technician certifies that the system was personally inspected and found conditions to=be as indicated on this report.
AUTHORITY HAV! NG JURISDICTION
20. Replaced fuse links
21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flame
24. Proper clearance -flame to filters
25. Exhaust fan in operating order
26. All filters in place
27. Fuel shut -off in on position T
28. Manual & remote set/seals in place
29. Replace systems covers
30. System operational & seals in place
31. Slave system operational
32. Clean cylinder & mount
33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
0 37. Service & Certification tag on system _
NOTE DISCREPANICES OR DEFICIENCIES BELOW
On this date, this pre- engineered fire s,p4ression system was inspected and operationally tested in accordance with the fire
suppression system requirements oJNF WA F -17A, 96 and the manufacturer's manual with the results indicated above.
X dr"" fv _
r4y.
c-SERVICE ECHNICIAN PERMIT NO. 'DATE: TIME: AM PM -- _CUSTOM ER'S AUTHORIZED AGENT
The above`Fvice technician certifies that the system was personally inspected and found conditions to=be as indicated on this report.
AUTHORITY HAV! NG JURISDICTION